I don't understand health insurance hmo or ppo.?

Question

Ok right now I do not have health insurance but my husband does. we just found out that I'm pregnant about 5 weeks, so I need to find health care quick. I DO NOT want to be a welfare mom and go on state assistance! I'd rather pay the $200 a moth and eat beans all month.(not serious)

So I need help finding a health insurance. what are deductables why are they like $5,000-$10,000 what does that mean. I'm sooooo confused I want a heath insurance provider that doesn't rip a whole in my pocket, but cover me during my pregnancy.

Answer 1

Congratulations on your pregnancy! As "wiseghy" said the Foundation for Health Coverage Education (www.coverageforall.org) is an excellent source for information, applications, and contact information for numerous programs in all 50 states plus Washington DC. You didn’t mention what state you were in but here is the link to the “Our Services” section of our site (http://coverageforall.org/our_services.h...  from there you can find your state and see what programs are available through your states matrix; however, my best suggestion would be to call the U.S. Uninsured Help Line at 800-234-1317. There Ernie, or any of our other experts, will be able to help you set up a personal profile to see what programs you are eligible for. After finding out what programs you are eligible for, see which one fits you best. Then you can return to our site and download the application to the program so you can have them filled out before you walk into the office. We hope if nothing else that this information helps out a little bit and remember to pass the information along to people you know are looking for coverage. You never really know when this information will be helpful to someone.

Answer 2

If your husband has insurance, the best bet would be to see if he can have you added to his coverage as a family member.

Answer 3

If your husband has group insurance through his employment you'll need to get on his policy if possible. Other than that you're out of luck because no insurance company will write an individual policy on someone pregnant. That's like trying to get homeowners insurance after your house burns down. Even if you could most have a waiting period of 12 months or more before they'll pay any benefits.

Stay away from discount cards. The amount you save, if you can find a doctor that will take the card, will be the same as if you paid cash.

Your only other option would be to set up a payment plan with the doctor and hospital. The amount you'll pay would be about the same as the extra premiums with any maternity coverage.

Answer 4

First off, congrats on your pregnancy!  This is a blessing, and I'm glad you are excited about it all! I answer this question assuming you are in the US, where we have a very complex combination of private and public insurance.

Unfortunately, buying individual insurance from the private market AFTER you already have a documented medical condition can be difficult thing. You will need to work carefully to be sure you can get coverage. The question is not one of eating beans, but rather acting in a smart way so as to avoid a risky delivery plus about $20K in delivery costs that will end up on your credit record for many years.    

First, you need to find out when open enrollment is on your husband's plan, so that you can get added at that time. Even if you can't on in the next 4 months, perhaps coverage is available for your baby later. Work with the employer and the broker to see what EXACTLY the rules are adding mid-plan year. Probably, you must prove you were covered elsewhere, except during open enrollment, but maybe an exception of some kind is available.  

If you can't get on a regular private insurance program, depending upon your state, there may be a PUBLIC pregnancy program that is available. Often, (but not always), these are called AIM programs  (access for infant mothers). These are not "welfare" exactly, but they are publicly funded, and are made available to make sure that babies and their mothers make this transition in good health.  

This will vary a lot by state.  Depending on your state, I suggest calling this non-profit:  

www.coverageforall.org.  

Ask for Ernie, as he is the supervisor and is the best resource.

If you maintain a good attitude and ask for people's advice and help without desperation, (even if you are) you are more likely to collect the information you will need. If worse comes to worse, payment plans can be worked out with certain hospitals and doctors as well. I'm pretty sure you can get help, if your family income is not too high.

Answer 5

Your pregnancy may not be covered because of waiting periods if you select an individual plan (non group policy).  See if your husband can enroll you through his employer on his insurance plan.  Otherwise see if you qualify for medicaid and go with it.  Your baby could be covered by your husbands plan.

And of course, congratulations and good luck!

Answer 6

Unless it is open enrolklment at your husband's job, you will not be able to be added to his insurance. The baby can be added after birth if done so within 30 days after birth. Your pregnancy will not be covered by any individual policy as it will be considered pre-existing. You will have to wait until the next open enrollment period for coverage so make sure you know when that will be. It's possible that some of the charges would be covered if you are still pregnant at that time.

Contact your OB and hospital. They ALL have discounted rates for maternity and delivery. Make sure that you budget for things like epidurals.